journal article·2025-11-28Open access

Acute Effects of Physical, Cognitive, and Combined Exercise on Executive Functions During Postural Challenge in Older Adults with Mild Cognitive Impairment

Eirini Giatagani, Konstantina Dipla, Dimitrios A. Patikas, Lida Mademli

Applied Sciences· Volume 15· Issue 23

Abstract

Mild cognitive impairment (MCI) compromises executive control, yet brief exercise may yield acute cognitive benefits. We tested whether a single ~10 min bout of physical, cognitive, or combined physical-cognitive exercise modulates Stroop performance in older adults with MCI (MoCA) under heightened postural demand (tandem stance). In a within-subject design (n = 28), participants completed three sessions: physical, cognitive, and combined physical-cognitive exercise protocols. Stroop performance was tested seated and in tandem stance pre-exercise (order counterbalanced) and again in tandem stance post-exercise. Pre- and post-exercise physiological markers (heart rate, blood pressure, SpO2, glucose) and workload (NASA-TLX) were recorded; balance was assessed with a 30 s Tandem Stance Test. Posture (seated vs. tandem) did not affect baseline Stroop levels. Across sessions, Stroop performance improved acutely after the physical and cognitive exercises—most robustly after the physical testing—whereas the combined condition produced the smallest changes. The physical and combined sessions increased heart rate and systolic pressure; SpO2, diastolic pressure, glucose, NASA-TLX, and tandem-stance balance were unchanged among all sessions. These results indicate that a single light- to moderate-intensity session can acutely enhance executive function for MCI and that a challenging posture does not impose any dual-task cost. Furthermore, single-task exercise may be more effective for rapid cognitive gains than combined mental and physical protocols in individuals with MCI.
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Research context

OpenAlex topics: Balance, Gait, and Falls Prevention · Stroke Rehabilitation and Recovery · Older Adults Driving Studies

SciVX discovery tags are terminology-based. OpenAlex topics are source-provided classifications.

Affiliations

School of Physical Education and Sports Science at Serres, Faculty of Physical Education and Sports Sciences, Aristotle University of Thessaloniki, Ag. Ioannis, 62500 Serres, Greece

School of Life and Health Sciences, University of Nicosia, Nicosia 2417, Cyprus

References (49)

Show source-provided references
1. Worldwide Prevalence of Mild Cognitive Impairment among Community Dwellers Aged 50 Years and Older: A Meta-Analysis and Systematic Review of Epidemiology Studies
2. Mild Cognitive Impairment as a Diagnostic Entity10.1111/j.1365-2796.2004.01388.x ↗
3. Effects of Acute Bouts of Exercise on Cognition10.1016/S0001-6918(02)00134-8 ↗
4. The Cognitive Reserve Hypothesis: A Longitudinal Examination of Age-Associated Declines in Reasoning and Processing Speed10.1037/a0014012 ↗
5. Cognitive Reserve in Aging10.2174/156720511795745320 ↗
6. The Adaptive Brain: Aging and Neurocognitive Scaffolding10.1146/annurev.psych.59.103006.093656 ↗
7. Aging of Cerebral White Matter: A Review of MRI Findings10.1002/gps.2087 ↗
8. Fan, C., Li, H., Chen, K., Yang, G., Xie, H., Li, H., Wu, Y., and Li, M. (2025). Brain Compensatory Activation during Stroop Task in Patients with Mild Cognitive Impairment: A Functional near-Infrared Spectroscopy Study. Front. Aging Neurosci., 17.10.3389/fnagi.2025.1470747 ↗
9. Working Memory and Control of Attention in Persons with Alzheimer’s Disease and Mild Cognitive Impairment10.1037/0894-4105.21.4.458 ↗
10. Attention and the Control of Posture and Gait: A Review of an Emerging Area of Research10.1016/S0966-6362(01)00156-4 ↗
11. Improving Dual-Task Control With a Posture-Second Strategy in Early-Stage Parkinson Disease10.1016/j.apmr.2018.02.013 ↗
12. Busch, N., Zinchenko, A., Halle, M., and Geyer, T. (2025). Withstand Control: Standing Posture Differentially Affects Space-Based and Feature-Based Cognitive Control through Enhanced Physiological Arousal. Sci. Rep., 15.10.1038/s41598-025-11692-6 ↗
13. Does Body Posture Reduce the Stroop Effect? Evidence from Two Conceptual Replications and a Meta-Analysis10.1016/j.actpsy.2022.103497 ↗
14. Studies of Interference in Serial Verbal Reactions10.1037/h0054651 ↗
15. Half a Century of Research on the Stroop Effect: An Integrative Review10.1037/0033-2909.109.2.163 ↗
16. An Acute Bout of Dynamic Sitting Exercises Improves Stroop Performance and Quality of Sleep in Older Adults with Cognitive Impairment10.4103/iahs.iahs_23_19 ↗
17. Be Smart, Exercise Your Heart: Exercise Effects on Brain and Cognition10.1038/nrn2298 ↗
18. A 2 Year Multidomain Intervention of Diet, Exercise, Cognitive Training, and Vascular Risk Monitoring versus Control to Prevent Cognitive Decline in at-Risk Elderly People (FINGER): A Randomised Controlled Trial10.1016/S0140-6736(15)60461-5 ↗
19. Influence of Acute Combined Physical and Cognitive Exercise on Cognitive Function: An NIRS Study10.7717/peerj.7418 ↗
20. Pellegrini-Laplagne, M., Dupuy, O., Sosner, P., and Bosquet, L. (2022). Acute Effect of a Simultaneous Exercise and Cognitive Task on Executive Functions and Prefrontal Cortex Oxygenation in Healthy Older Adults. Brain Sci., 12.10.3390/brainsci12040455 ↗
21. Brain Small-Worldness Properties and Perceived Fatigue in Mild Cognitive Impairment10.1093/gerona/glab084 ↗
22. Relationships between Features of Autonomic Cardiovascular Control and Cognitive Performance10.1016/j.biopsycho.2009.03.003 ↗
23. Exercise Training for Cognitive and Physical Function in Patients with Mild Cognitive Impairment: A PRISMA-Compliant Systematic Review and Meta-Analysis10.1097/MD.0000000000030168 ↗
24. The Effects of Dual-Task Training on Cognitive and Physical Functions in Older Adults with Cognitive Impairment; A Systematic Review and Meta-Analysis10.14283/jpad.2022.16 ↗
25. Neural Mechanisms of Dual-Task Interference and Cognitive Capacity Limitation in the Prefrontal Cortex10.1038/nn.3667 ↗
26. Elbanna, S., Cortez, C., Smith, E., Rattanavong, J., Ross, S., Kline, G., Wiechmann, A., Dyson, H., Mallet, R.T., and Shi, X. (2025). Enhanced Cerebral Oxygenation during Mental and Physical Activity in Older Adults Is Unaltered by Amnestic Mild Cognitive Impairment. Front. Physiol., 16.10.3389/fphys.2025.1535045 ↗
27. An Acute Bout of Exercise Improves the Cognitive Performance of Older Adults10.1123/japa.2015-0097 ↗
28. Glucose Improvement of Memory: A Review10.1016/j.ejphar.2004.02.043 ↗
29. Determinants of Maximal Oxygen Transport and Utilization10.1146/annurev.ph.58.030196.000321 ↗
30. Effects of Aerobic Training on Cognition and Brain Glucose Metabolism in Subjects with Mild Cognitive Impairment10.3233/JAD-150033 ↗
31. Relations between Aging Sensory/Sensorimotor and Cognitive Functions10.1016/S0149-7634(02)00073-8 ↗
32. Cognitive Motor Interference While Walking: A Systematic Review and Meta-Analysis10.1016/j.neubiorev.2010.08.008 ↗
33. The Interplay between Cognitive and Motor Functioning in Healthy Older Adults: Findings from Dual-Task Studies and Suggestions for Intervention10.1159/000322197 ↗
34. The Motor Signature of Mild Cognitive Impairment: Results from the Gait and Brain Study10.1093/gerona/glu155 ↗
35. The Effects of Acute Exercise on Cognitive Performance: A Meta-Analysis10.1016/j.brainres.2012.02.068 ↗
36. Golden, C.J., and Freshwater, S.N. (1978). Stroop Color and Word Test: A Manual for Clinical and Experimental Uses, Stoelting.
37. Scarpina, F., and Tagini, S. (2017). The Stroop Color and Word Test. Front. Psychol., 8.10.3389/fpsyg.2017.00557 ↗
38. Borg, G. (1998). Borg’s Perceived Exertion and Pain Scales, Human Kinetics.
39. Psychophysical Bases of Perceived Exertion10.1249/00005768-198205000-00012 ↗
40. Devos, H., Gustafson, K., Ahmadnezhad, P., Liao, K., Mahnken, J.D., Brooks, W.M., and Burns, J.M. (2020). Psychometric Properties of NASA-TLX and Index of Cognitive Activity as Measures of Cognitive Workload in Older Adults. Brain Sci., 10.10.1101/2020.10.26.20219881 ↗
41. Interpreting the Need for Initial Support to Perform Tandem Stance Tests of Balance10.2522/ptj.20110283 ↗
42. A Study on the Impact of Acute Exercise on Cognitive Function in Alzheimer’s Disease or Mild Cognitive Impairment Patients: A Narrative Review10.1016/j.gerinurse.2024.06.019 ↗
43. High Impact Running Improves Learning10.1016/j.nlm.2006.11.003 ↗
44. A Meta-Analytic Review of the Effects of Exercise on Brain-Derived Neurotrophic Factor10.1016/j.jpsychires.2014.10.003 ↗
45. Bellini, A., Nicolò, A., Bazzucchi, I., and Sacchetti, M. (2022). The Effects of Postprandial Walking on the Glucose Response after Meals with Different Characteristics. Nutrients, 14.10.3390/nu14051080 ↗
46. Zhang, W., Liu, H., and Zhang, T. (2023). Immediate and Short-Term Effects of Single-Task and Motor-Cognitive Dual-Task on Executive Function. PLoS ONE, 18.10.1371/journal.pone.0290171 ↗
47. Kuo, H.-T., Yeh, N.-C., Yang, Y.-R., Hsu, W.-C., Liao, Y.-Y., and Wang, R.-Y. (2022). Effects of Different Dual Task Training on Dual Task Walking and Responding Brain Activation in Older Adults with Mild Cognitive Impairment. Sci. Rep., 12.10.1038/s41598-022-11489-x ↗
48. Doi, T., Shimada, H., Makizako, H., Tsutsumimoto, K., Uemura, K., Anan, Y., and Suzuki, T. (2014). Cognitive Function and Gait Speed under Normal and Dual-Task Walking among Older Adults with Mild Cognitive Impairment. BMC Neurol., 14.10.1186/1471-2377-14-67 ↗
49. Effect of Voluntary Activation on Age-Related Muscle Fatigue Resistance10.1016/j.jbiomech.2008.01.019 ↗